Labor induction at full-term and post-term pregnancies

INTRODUCTION

Induction of labor is an intervention in the obstetrics, which aim is to achieve cervical ripening and stimulate contractions of uterus before beginning of labor. The purpose of our study was to evaluate efficacy of combinations of vaginal misoprostol, intracervical dinoprostone and Foley catheter at term with regard to mode of delivery and rate of emergency C-sections due to birth asphyxia.

MATERIAL AND METHODS

403 singleton pregnant women, who underwent pharmacological labor induction at term, were reviewed. Patients were divided into 2 main cohorts due to beginning of induction algorithm: vaginal misoprostol (66) or intracervical dinoprostone (337) consisting of 3 subgroups - PGE2 alone (184), PGE2+Foley catheter (125), PGE2+Foley catheter+PGE1 (28).

RESULTS

Comparison of maternal age, presence of cervical dilation and parity revealed no major differences between cohorts. Effectiveness of labor induction with misoprostol, dinoprostone and dinoprostone followed by Foley catheter were respectively 90.9%, 51.3%, and 82.8%. Addition of PGE1 was effective in 83% of patients with negative response to PGE2 followed by Foley catheter. ere was no statistically significant difference in rate of C-sections between dinoprostone and misoprostol cohorts, C-section due to birth asphyxia were insignificantly more frequent in PGE1 than in PGE2 cohort. Efficacy in the subgroup administered only dinoprostone was significantly higher in 40th than in 41th (p = 0.016).

CONCLUSIONS

Intracervical dinoprostone seems to be safer, but less effective in labor induction than vaginal misoprostol. Following PGE2 by other methods increased efficacy of induction in this cohort.

Effect of oligohydramnios on the accuracy of sonographic foetal weight estimation in at term pregnancies

OBJECTIVE

Ultrasound estimation of foetal weight is a very important aspect of antenatal care. The role of amniotic fluid volume as a potential factor which may impede the relevance of ultrasonographic foetal weight estimation is still questionable. The aim of our study was to evaluate the impact of isolated oligohydramnios on the accuracy of ultrasound foetal weight estimation in at term pregnancies when examination was performed within 48 h before delivery.

MATERIALS AND METHODS

The retrospective cohort study included 1831 women with low-risk, singleton, at term pregnancy. Estimated foetal weight (EFW) was calculated using Hadlock-4 formula. Exclusion criteria consisted of multiple pregnancies, active phase of labour, preeclampsia, foetal growth restriction, foetal anomalies, gestational diabetes mellitus and the evidence of intrauterine infection. Isolated oligohydramnios was defined as Amniotic Fluid Index (AFI) ≤50 mm without any other foetal anomalies. EFW and actual birth weight (ABW) were compared by calculation of: absolute error (AE), absolute percentage error (APE) and substantial error (SE) = APE >10%.

RESULTS

Participants were divided into 2 groups: Group 1: patients with normal AFI (50 ≤ AFI ≤250 mm; n = 1602) and Group 2: (isolated oligohydramnios, n = 229). There were not observed statistically significant differences between mean ABW and mean EFW in both groups (Group 1: p = 0.525; Group 2: p = 0.317). Mean AE in Group 1 was 221.8 g and 223.1 g in Group 2 (p = 0.919). Mean APE was 6.54% and 6.64% in Group 1 and 2 respectively (p = 0.816). SE ratio was 21.9% in Group 1 and 19.2% in Group 2. Underestimation to overestimation ratio in Group 1 was 1.01 and 0.84 in Group 2.

CONCLUSIONS

Amniotic fluid volume has limited impact on ultrasound foetal weight estimation. In oligohydramnios group there might be a tendency of overestimation of neonatal ABW.

Ochratoxin A: an improvement clean-up and HPLC method used to investigate wine and grape juice on the Polish market

A routine method appropriate for the determination of ochratoxin A (OTA) in wine, grape juice and grape juice drinks was described, and the occurrence of the mycotoxin was investigated in the most popular red wines, grape juice and grape juice drinks available on the Polish market. After clean-up on immunoaffinity column, samples were analysed by RP-HPLC using a fluorescence detector at 330 and 460 nm. The average OTA recoveries from spiked blank wine samples varied from 60 to 82%, and RSD% ranged from 5 to 14%. The OTA recovery for spiked grape juice and grape juice drinks were 80-100%, but the RSD% was between 7 and 10%. The limit of detection and limit of quantitation for all sample types were 0.5 and 2.0 ng l(-1), respectively. Fifty-three samples of red wine and seven samples of grape juice and grape drinks were assessed by means of this analytical procedure. OTA was detected in most wine samples (92%); its concentrations ranged from 2.2 to 6710 ng l(-1). In all grape juice and drink samples, OTA levels ranged from 1.6 to 64.7 ng l(-1).

[Determination of vitamins B1 and B2 in selected vegetable-fruit products]

A simple method was described to determine vitamins B1 and B2 in fruit and vegetable-fruit juices. Vitamins were extracted with perchloric acid and for their determination an ion pairing RP-HPLC technique with UV detection by 254 nm was applied. The average recovery for vitamin B1 was 85-104% and 94-105% for vitamin B2. The statistically estimated limits of identification and detection were respectively, for both vitamins: for B1: 0.008 and 0.0024, and for B2 0.0002 and 0.0007 mg/ml of product.

[Determination of vitamin C in selected fruit and vegetable products]

A simple method was described to determine vitamin C as L-ascorbic acid (after reduction of dehydroascorbic acid by means of dithiothreitol) in fruit juices, fruit and vegetable-fruit nectars. Ascorbic acid was analyzed by RP-HPLC technique with UV detection (254 nm). The average recovery of ascorbic acid was 92-103% and limits of identification and detection were 0.003 and 0.009 mg/ml of products respectively.